September 10, 2009

It has long been known that people with autoimmune diabetes (Type 1 and LADA) are very likely to also develop gluten allergies. Now a recent study suggests that T-cells in people with Type 1 diabetes may be overly sensitive to wheat and that this sensitivity may be related to the development of the Type 1 diabetes.

Many people in the low carb community welcome this kind of finding in that it reinforces the "carbs are evil and bread is the evilest of carbs" thinking that often permeates that community.

But before we blame wheat for causing Type 1 diabetes it is worth looking a little deeper. The fact is humans living in temperate climates in the Northern Hemisphere have been eating wheat-based diets for some five thousand years. But the sudden explosion of Type 1 diagnoses is about 30 years old.

Back in my wheat-saturated childhood in the 1950s Type 1 was extremely rare. I did not meet a single person who had it until I was 23 years old and I interacted with literally thousands of young people during that time period. There was no one with Type 1 in my college dorm. There was no one with Type 1 at work.

Epidemiological studies back up this anecdotal finding. The rate of development of Type 1 in children appears to have taken an upward turn in the 1970s then it really got going.

After explaining that "...the incidence of childhood-onset type 1 diabetes in Australia has doubled in the last 20 years, from 11.3 cases per 100,000 person-years in 1985 to 23.2 in 2002." It concludes

"The rising incidence and decreasing age at diagnosis of type 1 diabetes is accounted for by the impact of environment on children with lower-risk HLA class II genes, who previously would not have developed type 1 diabetes in childhood.

In short, something is happening now so that a large group of children with what used to be diabetes-related genes that occasionally caused Type 1, but not all that often, are now getting Type 1, children (and adults, too) who would not have developed it pre-1980.

The researchers attribute this to an environmental cause and suggests a few very unconvincing suggestions as what this environmental cause might be including increased exposure to rotavirus among babies in hospital nurseries.

The gluten/Type 1 wheat/Type 1 link should, if anyone was paying attention, have got some bright red signals flashing as to what the real environmental change producing this rise in Type 1 might be. The obvious question to ask is this. What is new in our environment since the late 1970s. Is it wheat?

No. Of course not. But what is new might be something that changes the way our bodies digest wheat, in particular, something that changes gut permeability so that the wheat proteins that for millennia made their way through the gut without getting into the blood stream where they could provoke antibody attack suddenly started leaking into the gut.And when you ask what change in our food supply happened since the late 1970s that had the ability to change gut permeability you find one huge possibility: Soy.

No one ate Soy in the 1950s except when they went to a Chinese restaurant. Even then, they avoided bizarrely exotic foods like tofu and black beans in favor of bland dishes flavored with a bit of salty American-made soy sauce.

But in the 1970s this changed dramatically. Soy began to be used as a protein extender in fast foods and packaged foods to the point where it is now virtually impossible to find a packaged food that does not have soy in it somewhere.

The public was sold the line that soy was health food--based on claims that were never substantiated, and many of which were proven false.

What the public does not know, and I learned only from reading Kaayla Daniel's book, The Whole Soy Story: The Dark Side of America's Favorite Health Food is that soy contains compounds called "saponins" which, as their name suggests, have a soapy quality. As you can read on page 240 of Daniel's book, Soy saponins damage gut mucosa and have been found in numerous studies to change the permeability of the gut. Since these studies were not funded by the huge food processors who inundate us with soy, you have never heard about them. You have now.

Any of you who have more than a passing interest in how the foods we eat affect our bodies owe it to yourselves to read the Daniel book. There is something eye-opening on every page, and Dr. Daniel documents each of her claims with rigorous citations to peer reviewed research.

Here is just one research study backing up the finding about the relationship of soy saponins to gut damage. There are many more.

If you have an inherited genetic tendency to autoimmune disease, and wish to preserve yourself and your children from developing autoimmune diabetes, this latest news about wheat might impell you to do two things.

1. Completely eliminate wheat and gluten from your diet.

2. Completely eliminate soy from your diet.

Because it is most likely the leakiness of the gut that allows large proteins into the bloodstream where they provoke immune attack, my guess is that eliminating wheat will merely allow some other large protein into your blood which will provoke immune attack. Perhaps, since there is something about wheat that seems to provoke attack on the insulin-producing beta cells, eliminating wheat might lower your risk of diabetes. But who knows what cells other proteins leaking through might resemble? Avoiding diabetes by upping your chances of developing Rheumatoid Arthritis, Multiple Sclerosis, or Lupus, it not a course I would recommend.

Instead, concentrate on keeping your gut membranes doing the job they were hired to do. Don't eat foods that will harm the cells on the barrier membranes that keep your food proteins where they were intended to go. In short, don't eat soy.

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comments:

I agree, Kaayla Daniel's book The Whole Soy Story is terrific and everyone should read it. Before I read it I had already reduced or eliminated most forms of soy from my family's diet when I was diagnosed hypothyroid and learned that soy inhibits thyroid function (we still occasionally use a small condiment amounts of traditionally fermented raw Japanese wheat-free tamari).

Ironically, my exposure to soy and gluten was greatly increased during the first two years that I was actively restricting carbohydrates (to lose the 20 pounds I gained after I started using a bread machine) because the low carb pita breads I consumed included soy flour and wheat gluten (as do many manufactured low carb grain products). These two cheap commodity ingredients are lower in starch, higher in protein, which enables food manufacturers to use them with abandon to create lower carb bread and foods that resemble their regular counterparts. I now purchase no manufactured foods labeled "low carb" and instead focus on real, whole foods that are naturally low in carbs instead of manufacturing manipulations to lower carb content. Except for the small amount of soy sauce I mentioned above, we are all on gluten and soy free diets (not difficult if you ditch the processed foods and make your own).

I also realized that via my prior use of the bread machine, I had also increased exposure to gluten, because doughs that included "vital wheat gluten" performed better with the fast rising times of the machine. After a couple years of eating "wholesome" homemade-machinemade bread and then a couple years of low carb bread I felt like 'stale bread', LOL.

Now that I know I have two copies of HLA genes that predispose to gluten intolerance, and testing has confirmed I make antibodies to gluten and soy, I'm not surprised that my health took a downward turn after those years of eating so much added gluten and soy.

I completely agree with you about the soy, but I think there's still more to consider with the wheat issue. The wheat and wheat products people consume now are simply not the same as the wheat and wheat products in 1950s America; too much has changed with the wheat breeds and the processing into product. It's comparing apples to oranges in too many ways.

Interesting post. It leaves me wondering about the many Asian populations where soy has been a common food for a long time. Are these populations experiencing issues with soy, or are they genetically adapted?

This is very interesting - I had an anaphylactic reaction to soy for the first time and was rushed via ambulance to the hospital. A year later I was diagnosed with type 2 for a month the re- diagnosed as type 1 diabetes at the age of 27.

Dr. Daniel documents that traditional Eastern populations ate relatively little soy, and what they ate was processed using complex fermentations that deactivated some of the problem compounds.

She also documents that none of the fermented soy products sold in the East today use the true traditional techniques, including some of the health food brands, because they are intensely time consuming.

Soy was first planted as a nitrogen-fixing crop for soil replenishment (like alfalfa). It's only been used as food for humans in Asia about 3000 years. Asians consume relatively small, condiment-sized portions of soy, not at all the way most Americans consume soy.

Daniels doesn't really say much very negative about the use of rather small amounts of traditionally produced Asian soy foods; she also mentions that it took many hundreds of years to perfect the techniques that largely eliminate or at least greatly reduce the downs-sides to human ingestion of soy. Her issue is mainly with the modern technology -driven mass production methods and short-cuts that have made soy foods cheap to make and sell (the very versions in found everywhere in typical supermarkets and Asian restaurants).

I reread the passage in The Whole Soy Story about the increase in faster, mass produced soy sauce using hydrolysis methods. It doesn't *quite* say that there are no traditionally fermented soy sauces products made or used Asia today, though it does say the short-cut products are now the dominate form even in Asia.

Traditional production methods take 6-18 months or more. Mass produced soy sauces using chemical hydrolysis techniques developed by Kikkoman during American-occupied post-war Japan, take only two days to make, not months or years. After the Americans left, disgruntled traditional shoyu makers went back to their old production ways, though major soy sauce producers went full steam ahead with the more profitable short-cut version.

There are people in many parts of Asia who still make a home-brewed soy sauce instead of buying it, though I'm sure their numbers are dwindling, as with all home-prepared fermentation techniques.

Not long ago we watched a show on the Food Network that featured footage of a multitude of large ceramic fermentation urns (waist or chest high) that were slow fermenting Korean soy sauce the old fashioned way. No doubt most people everywhere are buying the inexpensive short-cut soy sauces without knowing a thing about the production process, just like people now buy pickles and sauerkraut made quickly with vinegar instead of the traditional lacto-fermentation process using salt and time (which is raw and very probiotic - no Activia needed).

The Japanese shoyu/wheat-free tamari (raw and unpasteurized) I use is imported by a company in my area so I called them and asked some questions. They assured me it is made in a small batch, traditional two year fermentation process by a family owned and operated company (Ohsawa) that is over 150 years old and that Cooks Illustrated had pointed out the creation process difference in this product in their comparison testing of soy sauces. The slower, small scale production probably explains the huge price difference between Ohsawa products and Kikkoman types, too; this Ohsawa GF Tamari is nearly $20 for a 1 qt bottle, but that lasts us well over one year.

It seems nearly nothing is made the way it used to be made - it's all shortcuts and food technology creations - sigh. Is it any wonder we are so collectively sick? Our genes aren't prepared for so much change so fast - it took 2.5+ million years to make us and a few generations to break us.

thank you for pointing out that traditional use of soy in Asia was very different from today's use of mass produced products. I'll get the book you referenced, and search for traditional soy products. I'd like to be able to continue to use a little soy sauce for flavor, and also miso and natto occasionally.

If you are in the US you may wish to look for Ohsawa naturally fermented raw soy products, which are imported by Gold Mine Natural Foods of San Diego (www.goldminenaturalfood.com), available online and at 'natural' food stores. Ohsawa makes an excellent 3 year fermented raw hatchco miso paste (wheat & barley-free) which keeps a long time in the refrigerator (transfer from original vacuum packaging to a sterile glass jar).

I've not tried Ohsawa natto, but I know natto is an excellent source of the MK-7 form of Vitamin K2 (they body still needs to convert it to the MK-4 form we use, though). Vitamin K2 (quite different from K1 found in leafy greens) is emerging as an important nutrient 'team member' for proper placement of calcium, leading to good bone, dental and cardiac health.

I avoid instant miso powders, soups, and similar miso products, as the miso is no longer alive and probiotic and probably was made with a speedy untraditional method.

On another note, I've shopped at the huge San Diego 99 Ranch Market (chain of Asian supermarkets in the US) a few times this year and was really disturbed to see how much processed sugary and starchy 'junk' filled the shelves throughout the store. The quality of the food is as bad if not worse than what I see in conventional US supermarkets, though I can understand that's what keeps during very long warehouse and shipping times. The fresh produce section was fabulous and it was possible to choose your fish live from a tank and have it cleaned filleted, and even cooked right there (I'd love to know how fresh/old the frying oil was and not all the fish tanks looked clean, though).

I couldn't find even one coconut milk product there that didn't have preservatives, sulfites (keeps it white), and/or gums/thickeners, yet I can find such a plain coconut milk at Ralph's (owned by Krogers) at a very good price, 99¢/can (though I often make my own from fresh coconut now - it's very easy). Preservatives and cheap soybean oil were the norm in the packaged foods, and wheat as well as sugars (inc HFCS) were extremely common, too. I hardly bought anything (found some great coconut vinegar Vietnamese fermented anchovy fish sauce, canned mackerel, though). Mostly I observed. The only grocery stores in Asia I have experienced for comparison were in Japan during a brief visit to friends in 2000, and I remember a great percentage of traditional, real foods (though like in any industrial country, there were plenty of processed foods, too). And when I visit SF, I love strolling Chinatown at 5pm as people shop for their dinner at the bustling Mom & Pop produce & live seafood stores.

Interesting link indeed. I have assumed the increased toxicity of wheat came from the "green revolution" breeding programme, and I suspect soy will also have been a victim of this (it's not grown in the UK, but we get it in all manner of processed foodlike substances).

I read in a local paper (so it may not be true) that although still rare, the greatest increase in Type 1 has been in the non-autoimmune type. This appears to be happening only in parts of the UK, suggesting some local environmental factor. Is this also occurring in the US?

I don't believe there is such a thing as "non-autoimmune" Type 1 unless the article was inaccurately using the term "Type 1" to refer to forms of Type 2 where the beta cells are dead and the person requires insulin.

There is a much larger growth in Type 2 diabetes of all sorts, but the incidence of true, autoimmune Type 1 has more than doubled since the 1950s, and it probably has risen more than that when you add in the LADAs who are misdiagnosed as Type 2s. LADA is also autoimmune.

Beyond that, autoimmune disorders of all kinds appear to be on the upswing.

The non-autoimmune "type 1" diabetes reference in that article is merely one of the more recently diagnosed forms of MODY, and the point of the article is that this form of infant diabetes is in fact "monogenic" (i.e. MODY) rather than Type 1. It is also EXTREMELY rare.

Perhaps this could also be linked to the Chorleywood Process that has been used since the 1960's for industrial bread-making where much large amounts of yeast are used.See http://www.allotment.org.uk/allotment_foods/bread-making/chorleywood-bread-process.phpAccording to the above site, it has also been linked to Coeliac disease.

LHL - thanks for the link to the Chorleywood Process. I am not only gluten sensitive, but I am also very reactive to yeast. Before I went gluten free, bread was my favorite food. Not only are they adding extra wheat gluten, but the gluten content in wheat has been increased.

It appears that celiac disease has increased since the 1940's. You can hear Dr. Murry talk about this study. http://www.youtube.com/watch?v=DKwKQ7W9qlM He says that 1/100 are affected by celiac disease, but many doctors are now saying that 10-40% of the population may be negatively affected by gluten even though they test negative for celiac disease.

Zonulin is a molecule that loosens the tight junctions between the cells lining the intestine. In celiac disease, gluten causes an increased release of zonulin making the gut leaky. Increased zonulin is also seen with Type 1, MS and other autoimmune diseases. They have now identified zonulin as the precursor molecule for haptoglobin 2. http://www.sciencedaily.com/releases/2009/09/090907162322.htm

And it must be remembered that the conventional tests for celiac (antibody blood tests and intestinal biopsies for areas of flattened villi) cannot 'rule out' celiac disease or gluten intolerance. They can only 'rule in" the conditions.

Many, many people have negative test results, sometimes repeatedly, only to test positive at a later time (often years or decades later when significant damage has already occurred). If there are gluten issues in the family history, it is worth considering testing family members for the HLA genes that predispose to celiac/gluten intolerance instead of waiting until damage is so advanced that it finally triggers a positive result.

The issue of soy consumption is certainly an issue, and adding to the problem is the fact that modern food processing techniques are radically different from those of our ancestors (including Asian ancestors who used more soy). But add to this the fact that some 70% of U.S. soy crops grown is genetically-modified (thanks to Monsanto). Like all biotechnology products, our regulators simply assume them to be unequivocally safe until proven guilty, which puts the burden of proof not on the biotech industry, but those who believe we should proceed more cautiously. I recommend reading the book "Intervention" by Denise Caruso for a more balanced perspective.

I learn so much from your blog! This post makes me wonder ... I don't have Type 1 and as far as I know, autoimmune-related conditions don't run in my family. But I drink soy milk and have for a few years now, and for the past year I've used soy protein isolate in small amounts. I wonder how long it takes for saponin-related changes to occur? If I stop both of those things, and only eat black soybean chili infrequently, can I not worry about using bran? What about flax meal? Or the Eades' Magic Rolls--they include vital wheat gluten and I substitute sprouted rye grains for the flour component.

Many autoimmune disorders appear to require the particular genes to take place. If you have no family history of any autoimmune disorder, you probably have less to worry about re grains. I don't have such a history and have no markers for any kind of inflammation, so I do eat some wheat. I don't eat soy mostly because it gives me intense and unpleasant hormonal symptoms.

With a family history of Type 1 or another strong autoimmune history I would avoid both soy and gluten, especially when feeding children.

A family history can appear quite "clean" for gluten related issues, but without the gene and antibody testing, it's pretty hard to rule it out. The age of medical specialization too often fails to connect the diverse family history dots and most practitioners are not up to date on the latest gluten research.

I certainly wouldn't have guessed gluten, soy, or casein were an issue for my family until I was tested for antibodies and genes. I developed a hunch while looking into gluten for a friend who has three kids with diverse but suspiciously gluten-related health issues, actually. Turns out I have two genes that predispose to gluten sensitivity (but not necessarily celiac and GI symptoms). That means each of my parents have at least one copy. I'm quite sure others in my family have the genes, due to recent suspicious health conditions like spondylolithesis popping up, etc.

Until a dozen years ago, no one in my family would have thought diabetes was an issue, either, but now a strong history is rapidly developing (me with GDM/IGT which would be T2 if I ate to the USDA food pyramid), an uncle and cousin T2 for a decade, and now one of my parents diagnosed (and the other parent probably IGT). The family worry was always about CVD because of my grandfather's premature death from MI, but it's other conditions that are now striking.

I think modern lifestyles and our environment (including the modern industrial diet which has rapidly changed even in the past few decades) are hastening the incubation period for these diseases to surface and present. But in individuals, the manifestations of gluten and soy often are so diverse that the dots are extremely hard to connect unless one is looking for connections.

And the gluten research has just begun to scratch the surface. Most practitioners learned in medical school that celiac was very rare and primarily presented as failure to thrive in infants, yet middle aged adults with long histories of symptoms are increasingly diagnosed gluten-intolerant. The practice of medicine is very slow to catch up with the research (unless there's an expensive drug or equipment to peddle, of course). In this case, it's more profitable to treat the symptoms instead of determining the cause and eliminating the trigger.

I'm the only one diagnosed with hypothyroidism but I suspect it also affects at least one younger sister (I finally got her to get the actual TSH numerical result and it is in a suspicious range that some doctors would consider treating with thyroid hormone, but her doctor says she's "fine" and she's ok with that - instead she suppresses symptoms in other ways. She had suddenly high cholesterol levels (in the 600s) postpartum when she was 33 yo, which I think was a missed hypothyroid episode, but instead she was told to stop breastfeeding and take statins, which led to antidepressants, etc.

The same sister and I have also had lipomas (very common fat tumors that tend to run in families) removed, which some on the gluten forums seem to think is gluten-connected, though I can see that being so common it could also be coincidence. But my vet says that in her experience, dogs on kibble get lipomas a lot and dogs on canned food far less often. My lipoma suddenly appeared (chicken egg sized) after a few years of higher gluten exposure from bread machine baking followed by gluten-enhanced low carb bread products. I'm still looking for more than anecdotal evidence on that connection. Her daughter is the one that has the spine/vertebrae issue that presented around age 10 or 11; she seems to live on cold cereal, skimmed milk, bread, noodles and cheese. Both daughters have myopia and wear glasses and dental crowding (mild central facial bone structure development issues can trigger these and could be due to lack of fat soluble vitamins).

Like me, my other younger sister also experienced infertility.

My uncle (he's only 3-4 years older than me) was diagnosed with MS in his early 40s, but not long after was diagnosed with advanced multiple myeloma 3-4 years ago. He passed away 6 mos ago at the age of 50. I don't know much about the MS with him; the cancer and keeping him alive was the main focus the last few years so who knows. The drugs really messed up his nerves so any MS symptoms were moot. Like me, he was skinny as a rail until age 30, then quickly put on just a bit too much weight, and remained moderately overweight until he became gravely ill. He was always a very fussy eater with an extremely limited range of foods he'd eat (all pretty much high carb and fried junk, too).

The women on my mom's side in all the generations I have known all seem to be prone to arthritis in the hands, but I don't think it is rheumatoid arthritis. The enlarged knuckles of my grandmother, great-aunts, and my great-grandmother are quite memorable, though my mom and her sisters seem to have milder cases than than the previous generation.

I have osteo-arthritis in my neck (it began bothering me in my late 20s probably triggers by overused muscle injuries and bad habit carrying heavy book bags and purses. I also developed arthritis in one index finger knuckle two years ago. The knuckle pain has responded quite well to a gluten-free diet the past 6 months. I think at least one of my younger sisters (early to mid 40s) has the beginnings of arthritis in the knuckles.

"Beyond that, autoimmune disorders of all kinds appear to be on the upswing."

Also asthma and all manner of allergic conditions: all things with a genetic basis but some environmental factor(s) seem to be triggering gene expression. It's fascinating (like watching a train wreck) to see so many potential triggering factors come to light.

Hey yes, there was a fairly famous incident in Italy which was caused by dust from the ships unloading soy in the local docks.

I had gallstones back in my twenties: one of the consultants then opined that this was yet another condition which was becoming more widepread and affecting people outside of the classic "fat, fair, female, forties, fertile" population. An aunt also had them, and dyslipidemia is widespread in the family: I didn't know this connection to celiac before.

The other night I attended a Keystone Symposia reception with my husband. The guests were mostly local San Diego scientists (and spouses) who've organized past Keystone meetings (Keystone is an organization that runs research science conferences). Near the end of the reception I had a wonderful but too brief conversation about food and diet with one of the scientists. She noted that she's worried the increased rates of some diseases and earlier incidence ( like T2DM) possibly being connected to the advent of gene splicing in our food supply. Unfortunately we had to conclude our conversation just as it became most interesting.

I can not express how I feel knowing that I am not the only person on this planet who knows gluten/soy is really a killer. Ten years ago I was so near death from a bowl obstruction not to mention I am early fifties now and my stomach looks like a butt. I missed my son who I had with help from invetro due to infertility his first day at kindergarten in ICU. Very sad experience. Prior I was told I had developed type 1 diabetes at age 27. I never believed it always thought there was something underlying. When my son now sixteen developed asthma at age three used in hailers and asthma meds never ever got rid of nasal congestion/cough I decided to dig deeper only to now find out we are allergic to gluten/soy dairy. I think its horrible that two people had to go where we had to. My son is receiving laser treatment and taking supplements feeling and looking better. On the other hand I am on disability for hashimoto's disease with goiter severe neuropathy and two stents in my right artery I am noticing some relief avoiding gluten/soy and eating grass fed beef and natural chicken. Feel free to comment on this horror of a life experience I would love to hear from you. I really need the book.

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I was diagnosed with diabetes in 1998. Since then I've kept my A1cs in the 5.0-6.0% range using the techniques you'll find explained at The main Blood Sugar 101 Web Site, where you'll also find extensive discussion of the peer-reviewed research that backs up the statements you read here.

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